Ulcerative colitis
Journal
Nature Reviews Disease Primers volume
Journal Volume
6
Journal Issue
74
Date Issued
2020
Author(s)
Siegmund B.
Le Berre C.
Ferrante M.
Shen B.
Bernstein C.N.
Danese S.
Peyrin-Biroulet L.
Hibi T.
Abstract
Ulcerative colitis (UC) is a chronic inflammatory bowel disease of unknown aetiology affecting the colon and rectum. Multiple factors, such as genetic background, environmental and luminal factors, and mucosal immune dysregulation, have been suggested to contribute to UC pathogenesis. UC has evolved into a global burden given its high incidence in developed countries and the substantial increase in incidence in developing countries. An improved understanding of the mechanisms underlying UC has led to the emergence of new treatments. Since the early 2000s, anti-tumour necrosis factor (TNF) treatment has significantly improved treatment outcomes. Advances in medical treatments have enabled a paradigm shift in treatment goals from symptomatic relief to endoscopic and histological healing to achieve better long-term outcomes and, consequently, diagnostic modalities have also been improved to monitor disease activity more tightly. Despite these improvements in patient care, a substantial proportion of patients, for example, those who are refractory to medical treatment or those who develop colitis-associated colorectal dysplasia or cancer, still require restorative proctocolectomy. The development of novel drugs and improvement of the treatment strategy by implementing personalized medicine are warranted to achieve optimal disease control. However, delineating the aetiology of UC is necessary to ultimately achieve disease cure. ? 2020, Springer Nature Limited.
SDGs
Other Subjects
acetylsalicylic acid; adalimumab; azathioprine; biological marker; corticosteroid; golimumab; infliximab; interleukin 23; interleukin 9; Janus kinase inhibitor; mercaptopurine; methotrexate; microRNA; tofacitinib; ustekinumab; vedolizumab; Article; artificial intelligence; cancer risk; clinical practice; colorectal cancer; differential diagnosis; disability; disease severity; echography; endoscopy; extracellular trap; health; heredity; histopathology; homeostasis; human; immune response; intestine function; lamina propria; medical history; nonhuman; pathophysiology; patient care; personalized medicine; priority journal; quality of life; risk factor; screening; T lymphocyte; ulcerative colitis; global health; mass screening; procedures; ulcerative colitis; Colitis, Ulcerative; Global Health; Humans; Mass Screening; Risk Factors
Type
journal article